Pages

Thursday, December 30, 2010

As 2010 closes out, most of us find ourselves making resolutions for the New Year. Whether you want to change jobs, lose weight, quit smoking or find a mate, the changing of the calendar is an opportune time for self-improvement and for reflection.

Last year approximately 45% of women and 32% of men resolved to lose weight and increase their physical fitness. Of those, studies show that 80% had failed and abandoned their resolution by Valentine's Day. The best chance to lose weight and to keep the pounds off is when a strong support system is in place. OPC has resolved to help amputees in the Maryland and Northern Virginia area keep their weight loss resolutions!

Did you know that prosthetic components are classified according to activity level and weight limitations? Prosthetic choices are drastically impacted by the weight of the patient. Those with a higher weight are afforded fewer options and are not eligible for bionic devices.

Consider this: currently there are approximately 150 versions of feet on the market. Weighing more than 220 pounds eliminates 50% of the feet, leaving the amputee with 75 options. For the amputee weighing more than 275 pounds, the individual is left with only 36 feet from which to choose. When the amputee weighs over 300 pounds, their prosthetic choices have been limited to approximately 10 custom made, high impact feet.

If limited prosthetic choice is not enough motivation to shed the pounds, consider the strain that is being placed upon the residual limb. Socket fit and comfort are compromised by obesity. Sores and bone spurs are common occurrences for the overweight amputee.

OPC is committed to fostering healthy lifestyles for our patients. In the coming weeks we will be launching a program to help amputees in the area become more physically active and to achieve a healthy weight. In future blogs we will be exploring additional limitations and obstacles that the overweight amputee faces.

We are excited about our ground breaking program so stay tuned for more information! Together, we can all be healthier in 2011.

Tuesday, December 28, 2010

OPC would like to congratulate Touch Bionics for being awarded the 2010 Best of What's New Award from Popular Science magazine for their ProDigits solution. The award is bestowed on 100 products that have made the greatest impact in their designated category.

ProDigits is a remarkable prosthetic device for amputees with finger amputation(s). The prosthetic fingers are powered and controlled individually which enables the amputee to isolate finger motions. With training, patients have regained the ability to complete many of the tasks which before seemed nearly impossible, including typing and playing the piano. The individually powered and fully articulated digits reflect the movements and motions of the human hand that were not thought possible before this technology.

The ProDigits are the first to provide myoelectric control features. Myoelectric control utilizes advanced software to interpret the electrical signals released from the remaining limb. The software has a "learning" feature," enabling the output to evolve and to become personalized for each user.

Miniscule electrodes are fitted within the socket in strategic locations. As the individual attempts to move the amputated finger, the electrode detects the signal emmited by the limb. The software interprets the signal and moves the prostheses accordingly. The control of the prosthesis becomes natural for the amputee.

Because each ProDigit contains its own control and power supplies, the clinicians are able to make refined adjustments to receive optimum results using Bluetooth technology. The patient has a limited ability to make changes it grasp strength etc.. ProDigits is is a powered device and must be charged regularly.

The inclusion of myoelectric technology, which has never before been available in this form, makes the ProDigits Solution truly revolutionary. Individuals may benefit from this prosthetic innovation regardless of the number of fingers that have been amputated. Although each case should be evaluated individually, it is recommended that the finger amputation be at the transmetacarpal (just below the knuckle) level.

If you are an upper extremity amputee, this device might help restore more function to your everyday activities. The clinicians at OPC have experience fitting devices from Touch Bionics which have yielded amazing results. If you have questions about ProDigits Solution and feel that you might benefit, give us a call.

Thursday, December 23, 2010

In many ways, the relationship that the amputee develops with his or her prosthetist is more important than the one which was developed with the surgeon. Once the limb has been stabilized and is healthy, the surgeon plays a minimal role in the amputee's life. The prosthetist often becomes the first line of defense against residual limb issues, and the surgeon contacted only when all other remedies have been tried and have been deemed unsuccessful.

Choosing a prosthetist can feel daunting. It is often helpful to begin your search by asking several amputees in your area who they use. Be sure to ask if they are pleased with the care they are receiving; it is surprising how many amputees are not satisfied with their prosthetic care.

Utilize the initial consultation to ask questions and to learn about the philosophy of the practice. Remember that you are the client and that you are conducting the interview. It may be helpful to have your questions written down before the consultation. The following questions might help guide your interview.

1. Where are the prosthetics manufactured and maintained? Does the practice have the ability to create the devices in-house or are they prepared by a third party?

At OPC the prosthetics are manufactured on site. "In house" production reduces the time an amputee must wait to receive the prosthesis. We understand the importance of a prosthesis to the amputee and strive to provide a quick turn around time from casting to device delivery.

2. What does the practitioner envision his or her role to be in your rehabilitation?

We believe that an open line of communication between the practitioner and the amputee is paramount. When asked about his role, Elliot explained that he believes, "The prosthetist helps to navigate and to serve as a resource. It is important that a prosthetist is willing to offer choices. My first job is to listen."

3. Does the practitioner have experience with bionic devices and the latest technology? Ask about current certifications and devices that have been fit on other patients.

Not all prosthetists have received training on computerized limb components. New products are being introduced into the prosthetic market yearly. The practitioners at OPC strive to stay abreast of the latest innovations.

We believe that it should be left to the amputee to judge whether or not a component works for them. After all, the amputee is the person wearing the device. We provide the patient with options and our professional opinion, but ultimately the choice is yours.

4. What is the typical wait time to be scheduled for adjustments or to trouble shoot prosthetic issues?

We realize that there is little more than can ruin an amputee's day than an ill-fitting, uncomfortable socket. We are often able to see patients within 24 hours to address issues or to provide adjustments. Because our devices are manufactured on site, we are often able to remedy the issues during a single visit.

Choosing a prosthetist is a decision that should be carefully weighed. We are proud to be a practice which offers compassionate, knowledgeable, innovative care while being equipped to manufacture and repair on site. Remember that the prosthetist should be part of the team, but the amputee should always be the leader.

If you are interested in meeting with one of our practitioners, please give us a call (703) 698 5007 or drop us an email (info@opc1.com). We will offer Skype consultations, at no charge, beginning in January. Let's talk about how we can help you achieve your goals. We would love to be a part of your team!

Tuesday, December 21, 2010

Historically speaking, advances in the field of prosthetics occur primarily during times of war and conflict. This phenomenon is easy to explain--funding for prosthetic research is increased as the surge of wounded military men and women increases. The number of military personnel that sustain amputations can be correlated directly to the amount of funding delegated for research.

In 2007 the Defense Advanced Research Projects Agency (DARPA) awarded two substantial grants to fund what has been dubbed as "revolutionary prosthetics." The goal of the grants is to develop, create and implement "naturally functioning" upper extremity prosthetics. Although the focus of the program is on designing hands and arms, there is little doubt that a trickle down will occur and that all amputees may eventually benefit from the advancements.

The results of the nearly $150 million investment are starting to be yielded. Phase one of the project, the DEKA arm, is currently being fitted on select military personnel and is readying for market release in the future. From fully articulated fingers to replicating various degrees motion, this is an exciting advancement!

From socket design to form and function, the DEKA arm has re-energized research in the field of prosthetics. "The ultimate goal of this research program has been to provide a prosthesis that mimics the natural hand and arm." With phase one nearing completion, attention is being turned towards the neurological component.

In order to develop an arm that mimics natural movements and responds instinctively, an interface with the brain is necessary. Researchers at Johns Hopkins have been working on developing a communication system between the patient and the prosthesis.

A small electrode, approximately 3 mm in size, has been developed for implantation on top of the brain. Once in place, the electrode can communicate the brain's commands directly to the prosthesis. The neuro-electrode has been implanted in primates with astounding results! The primates are able to control their prosthesis in real-time with natural movements, even demonstrating the ability to press deliberately press keys on a keyboard using prosthetic finger isolation.

This is a remarkable time in the field of prosthetics. Advances are being made in directions that a decade ago were only explored in Science Fiction (Luke Skywalker from Star Wars). The practitioners at OPC are on top of the technology available not only today but also in the future.

Thursday, December 16, 2010

Every season creates unique issues for the amputee. In the winter there is often a struggle to keep the residual limb warm. Although the limb may feel cold within the prosthesis, most amputees complain of the frigid sensation at night. A cold residual limb can range from being uncomfortable to painful. Many amputees report an increase both in the frequency and the intensity of phantom limb pain when their limb is cold.

Investing in a few items can make the frigid temperatures more comfortable for the amputee. After the prosthesis and liner are removed, it is helpful to slip a soft tube sock over the residual limb. Keeping the limb covered in a breathable fabric will help to maintain heat.If the tube sock is too small or constricting, you might want to try using a child's ski mask hat. The fabric can be stretched over the limb and the makeshift cover will typically stay in place while sleeping.

Although wrapping a heating pad around the limb can make the you feel more comfortable, it is not always practical. It is not advised to utilize a heating pad for more than 20 minutes at a time. Keeping the limb warm throughout the night using a heating pad not only becomes cumbersome because of the cords, but dangerous.

On occasion the sock alone doesn't provide enough warmth. If your limb continues to feel cold despite being covered, you might want to try using disposable hand warmers to provide extra heat. Once activated, the hand warmers generate heat for up to eight hours. Now when the limb is extremely cold, try pulling on a tube sock, hold a warmer on the tip of your covered limb and then slip another sock on top to hold it in place.

A WORD OF CAUTION: it is imperative that the hand warmer never be placed directly on the skin. Because the residual limb has nerve damage and compromised circulation (a natural result of the amputation) the skin may not react normally to burning heat. When using heat or cold therapy, always utilize a barrier.

If you are not bottoming out in your prosthesis, you might benefit from placing a hand warmer in the bottom of your socket in the morning. The warmers need oxygen in order to generate heat, so some space is necessary for them to work. Many amputees have a sufficient void in the bottom of their prosthesis for the hand warmers to work, creating a warmed prosthesis during the frigid temperatures.

Keeping the limb from becoming chilled during the winter is a common struggle for amputees. Hopefully some of these ideas will help to make you more comfortable whether you are playing in the snow or watching it fall from inside your home. Do you have any other cold weather tips?

Tuesday, December 14, 2010

Shopping, especially for holiday gifts, can be an exercise in frustration. Frequently we are asked to provide gift suggestions for an amputee. We have compiled a list of functional and fun gifts for an amputee friend or family member. Although many of these items are available at a variety of retail stores, we have included links to amazon.com purely out of convenience.

Fuzzy and warm socks are often a welcome gift. Many amputees complain that the residual limb becomes cold on winter nights so sleeping with a cozy and soft sock over the limb can make the individual more comfortable.

The residual limb often benefits from a deep massage, especially when the muscles are sore. This Homedics Massaging Pillow provides a comforting massage that can be personalized according to an individual's preferences. Many amputees have reported that their use of this massage pillow has lessened the frequency and intensity of phantom sensations.

Many lower extremity amputees who rely upon a prosthetic frequently struggle to put shoes onto their prosthesis. A shoe horn is a simple stocking stuffer than can alleviate their shoe donning frustrations.

Walking in snow and ice is difficult for those with both limbs. When the individual is an amputee, it can become a terrifying feat. These removable cleats easily slip onto a variety of shoes, increasing traction and safety while walking on slippery surfaces.

For the amputee gamer on your list, you might want to consider the Wii Active Personal Trainer system. This program can be easily adapted to accommodate for limitations due to limb loss. It is also a great way to learn how to put equal weight through the prosthesis, decreasing the chances of developing osteoporosis!

Traveling presents unique obstacles for the amputee. This portable grab-bar is simple to apply and can make any shower accessible. It is compact and fits into the corner of a suitcase. If the amputee utilizes a bionic prosthesis, they may appreciate receiving a power strip to use when traveling. The amputee traveler often must rotate between charging their cell phone, computer and prosthesis due to limited electric outlets in hotel rooms.

If he or she doesn't travel far from home, they might appreciate a handicapped tag holder. This holder keeps the placard both protected and in a central location, allowing it to be easily accessible.

Slipping on a cold silicone liner can be miserable way to start the morning, especially during the winter. For a "luxurious" gift, consider a towel warmer. The liner can be placed into the heated box to be warmed before it is donned. There is little that feels better than slipping into a warm liner on a cold winter morning!

Although this list is by no means exhaustive, we hope that it has provided some helpful ideas to make shopping a little easier. Do you have additional gift suggestions? We would love to hear from you.

Wednesday, December 8, 2010

The unmistakable chill in the air can only mean one thing: winter is upon us. For some people, winter is dreaded as a season of long, dark nights and indoor activities. For others, the plunging mercury and the first falling snow flakes signal the return of a favorite activity- skiing.

If you are an experienced skier, there is an opportunity that don't want to miss. Jackson Hole Ski Resort, in association with Teton Adaptive Sports and OPC, is pleased to announce the third annual Adaptive Steep & Deep Camp. This camp is open to all amputee skiers, regardless of the level of amputation, who have adaptive ski experience. It is important to consider that this is not a program for the novice amputee skier.This four day program, scheduled from March 2-5 2011, is a unique opportunity for the intermediate and advanced skier to hone their skills under the instruction of Olympic and Para-Olympic skiers. If you are an advanced skier who is looking to gain big mountain experience, this program might be for you. Unlike other adapted sports programs, the Steep and Deep Camp is fully inclusive. Skiers are grouped by their skiing abilities, not by the level of disability that may be present.

Participants from previous years have raved about the program with many making plans to return this year. A participant from last year said this about the camp, “As an amputee, I usually ski with other adaptive skiers. I really enjoyed the opportunity to be grouped with other skiers based on my abilities and not by the equipment I use to move down the hill. The instructors with the camp were truly top-notch. I cannot wait to come back to the Steeps and Deeps of Jackson Hole next year.”

The Steep & Deep camp registration fee covers lodging for five nights at the Teton Mountain Lodge, all coaching, lunches and a banquet dinner, lifts fees, after ski activities. The registration fees have been subsidized and limited scholarships are available!

The camp has been heralded as the experience of a lifetime for the experienced adaptive skier. If you're itching for snow so that you can hit the slopes, and you feel comfortable with your ski abilities, you don't want to pass up this opportunity. Spaces are limited so don't delay and register soon. We hope to see you in Wyoming!

Tuesday, December 7, 2010

Our patients remain the motivating force driving us at OPC. We recognize that each individual has a unique set of circumstances that led them to our practice. Our patients set and accomplish goals, and we are honored that we able to be part of their journey.

We are inspired by our patients every day, and we want to use this blog as a vehicle to share their stories. An accomplishment does not have to be an Olympic feat in order to be awe-inspiring for others. Returning to work after an amputation, learning to ride a bicycle or participating in a charity walk can be monumental achievements after a limb loss.

Please allow us to celebrate and share your accomplishments. We want to inspire others by providing real life role models. If you are interested in sharing your story, please send us an email(eyegal@comcast.net). You may wish to use the following questions to guide your response.

1. How did you lose your limb and what is your level of amputation?

2. What were you doing before your limb loss that you feared you wouldn't be able to continue now that you are an amputee?

3. What was your greatest fear about living with a limb loss, and how did you overcome it?

4. Please explain the feat or accomplishment that you achieved. Remember, no goal is too small!

This is your opportunity to inspire others who may be starting their journey, or who may need motivated. We hope to hear from you--this is your chance to share!

Friday, December 3, 2010

On Tuesday night, November 30, 2010, the U.S. House ofRepresentatives passed the Injured and Amputee Veterans Bill ofRights (H.R. 5428) as part of a larger bill, H.R. 5953, the WomenVeterans Bill of Rights. Congressman Filner, Chairman of the House VACommittee, led the charge in placing this bill on the "suspensioncalendar," leading to a favorable vote in the House.

The bill now goes to the U.S. Senate for consideration in the closingdays of the 111th Congress. The hope is that the Senate will considerthis bill under "unanimous consent" procedures, where, if no oneobjects, it automatically passes the Senate. However, there are manybarriers that lie ahead, particularly with the contents of the WomenVeterans Bill of Rights, and it is very late in the Congressionalcalendar.

NAAOP is working hard to secure passage of this important legislationand will continue to do so in the days and weeks ahead. Other O&Porganizations have been supportive at critical stages. We call on allNAAOP members and friends in the O&P community to contact theirSenate offices and encourage passage in the Senate of the Injured andAmputee Veterans Bill of Rights (part of H.R. 5953 - the WomenVeterans Bill of Rights).

The Injured and Amputee Veterans Bill of Rights is designed to makequality orthotic and prosthetic care more consistent to veteransacross the country. The bill would require the VA to post on itswebsite and in every VA O&P clinic a list of rights that veteranshave. These rights include access to appropriate technology, apractitioner of the veteran's choice (both inside and outside the VAsystem), a second opinion with respect to treatment decisions, accessto a functional spare orthoses or prostheses, and several otherimportant provisions.

We hope you will take the time to make your support for thisimportant legislation clear to your Senators.

Thank you for your assistance and to those who assisted with theHouse victory, congratulations!

Thursday, December 2, 2010

Phantom limb pain is accepted by the medical community as a real issue despite the fact that little is known about the phenomenon. Researchers suspect that the pain is the result of both physical and neurological issues. The brain continues to try to communicate with the limb after amputation, resulting in discomfort and painful sensations for the amputee.

The rising numbers of amputees have rejuvenated interest in phantom limb pain during the past decade. In addition to traditional pharmaceutical treatments, many patients have been seeking alternative approaches. Mirror therapy is among the treatments that has shown promise for diminishing the pain felt by amputees.

Many may be surprised to learn that mirror therapy has its origins in the Civil War. In the North Officers who suffered battlefield amputations were often provided with a mirror while in their sickbed. The wounded Officer was instructed to look at the sound limb in the mirror to receive "mental relief" from the trauma.

Mirror therapy reemerged at the beginning of this century as a promising treatment for phantom limb pain. Several research studies have been conducted and, although it is not completely understood why, participants report a drastic decrease in pain and discomfort after mirror therapy. It is theorized that the brain is "tricked" into believing that a connection is being made to the missing limb. When the brain believes that a connection is made, the nerves stop misfiring resulting in diminished pain.

A survey of area pain clinics revealed that many physicians are open to utilizing mirror therapy as a treatment for phantom limb pain. Although self-guided protocols are available on the internet, experts recommend that the amputee be trained in order to yield optimum results. The use of a mirror in conjunction with visualization techniques has proved the most successful approach.

This article provides a good explanation of the treatment of phantom limb pain with mirror therapy. Have you ever tried mirror therapy? What do you think about this treatment approach?